Legislators seek to delay Medicaid reform

Monday

Apr 23, 2012 at 4:35 PM

Tim Carpenter

Proponents of delaying Gov. Sam Brownback’s reform of the $2.9 billion Medicaid program expressed confidence Monday a majority of legislators in the House and Senate want to throw the brake switch on the reform process.

Bipartisan sentiment exists to bring to a vote in both chambers next week a resolution proposing postponement by six months the implementation of Brownback's overhauled Medicaid program. That would push the start to July 2013.

The nonbinding expression of the Legislature’s sentiment is unlikely to influence the governor to abandon plans to issue managed-care contracts this summer for his retooled KanCare initiative and swing the operation into action Jan. 1.

Sen. Dick Kelsey, a Goddard Republican who helped author the resolution and the owner of Medicaid-funded businesses for nearly 15 years, said there was insufficient time to obtain necessary waivers from the federal government to launch the new operating model and to hire private companies to take over these services to poor and disabled Kansans.

"They are trying to change the entire Medicaid system," Kelsey said. "All of us are speculating to some degree. They say it will work. I say it won’t."

The senator’s role in the debate has been intriguing because of his investment in companies supported for years by Medicaid financing. Until 2008, Kelsey owned a company that operated a home for troubled boys in Goddard. He will end ownership of an alcohol and drug treatment business Tuesday.

At that point, he will still retain land and buildings rented to companies operating both enterprises.

Kelsey also said the Brownback administration’s point people on Medicaid reform, packaged by the governor as KanCare, don’t have enough experience with intricacies of securing a Medicaid program waiver from the U.S. Department of Health and Human Services. States must secure permission from the HHS' Centers for Medicaid and Medicare Services to deviate from a basic Medicaid format.

Leaders of Kansas' effort are Lt. Gov. Jeff Colyer and Cabinet secretaries at the Kansas Department of Health and Environment and the Kansas Department on Aging.

Senate Minority Leader Anthony Hensley, D-Topeka, said postponing substantive change would be prudent. Holding off for six months allows the 2013 Legislature to work through details of Brownback's reform, he said.

"We need another legislative session between now and when KanCare is implemented so we can have adequate legislative oversight," Hensley said.

Sherriene Jones-Sontag, the governor’s spokeswoman, said the state was expected to submit a Medicaid waiver application by Friday.

Hitting that mark would allow Kansas to avoid new federal requirements that states accept public comment on Medicaid waiver applications and demonstrate how those comments were incorporated into the final documents.

Sen. Laura Kelly, of Topeka, ranking Democrat on the Senate's budget committee, said the Brownback administration should present to the public precise information about how the waiver proposal would alter care under Medicaid.

"They're talked a lot about transparency and accountability," Kelly said. "There is no better way than to put it out there."

Brownback and top administration officials have been pushing for more than a year to reform Medicaid services to 387,000 Kansans in an attempt to control cost increases.

In the fiscal year starting July 1, the state is expected to pay an additional $44 million into Medicaid primarily due to a growing number of people seeking the services.

Brownback’s proposal to move to the managed-care model would turn the program over to three private companies. Most Medicaid participants have managed-care coverage, but the overhaul is the first time Kansas would tie the approach to disabled and elderly residents needing expensive, long-term services.

Members of the House and Senate expressed skepticism the change will create the projected $368 million in savings over five years because the governor vowed not to sacrifice coverage for participants or cut payments to health care providers.

Senate President Steve Morris, R-Hugoton, said he expected the Senate to pass the resolution seeking delay in Medicaid reform.

"The major concern is that it's moving too fast and people are not ready," Morris said.

He said withdrawing the state's developmentally disabled population from the new system, at least for one year, would reduce much of the tension about pending changes.

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